For many nursing home residents, a trip to the hospital can be a jarring experience — one that leaves them confused and stressed. Yet avoidable transfers happen far too often, not only disrupting a resident’s routine but also costing the U.S. healthcare system $2.6 billion annually.

When researchers at the University of Missouri recently looked at the decision-making process for whether or not to transfer nursing home residents to the hospital, they quickly discovered that it’s complicated — particularly for residents with cognitive impairment who may not be able to communicate their preferences.

Many people are surprised by the intensity of their response when a well-known person dies, and their feelings of sadness may last longer than they expect. In fact, that sadness and grief can be intense, and preliminary research suggests that grief after the death of a public figure looks very similar to grief over our personal relationships and can have comparable levels of intensity.